Posts Tagged ‘normal values usmle’

For Medical Students: Normal values for laboratory investigations, BP, and BMI (USMLE-friendly)

“We teach our students that they should not believe us… Do not believe your professors!” Dr. Kevin Hanretty, University of Glasgow, UK.

If some professors, somewhere, are teaching their students not to trust them, how come that you trust a colleague of yours? Therefore, the  source of the below information: Unless specified, most of the values are from “Step 1: Content Description & General Information 2012”, p. 22, www.usmle.org/pdfs/step-1/2012content_step1.pdf.  The remaining few are from “Reference Intervals for Laboratory Tests & Procedures”, ch.708, Nelson Textbook of Pediatrics, 19th ed, 2011.

*** To view and download a printer-friendly version, you can visit Google Docs at: https://docs.google.com/file/d/0B9fwLrrCPng0dTRyX1RzeFNjRlU/edit ***

Normal Values: Laboratory, BP, and BMI
Reference Range
Conventional Units SI Units
Serum Nonelectrolytes
Amylase, serum 25-125 U/L
Phosphatase (alkaline), serum (p-NPP at 30EC) 20-70 U/L
Alanine aminotransferase (ALT at 30EC) SGPT(serum glutamic-pyruvic transaminase) 8-20 U/L
Aspartate aminotransferase (AST at 30EC) SGOT(serum glutamic-oxaloacetic transaminase) 8-20 U/L
Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL 2-17 µmol/L // 0-5 µmol/L
Lipoprotein levels – Adult Treatment Panel (ATP) III Classification of LDL, Total, and HDL Cholesterol (mg/dL):Cholesterol mmol/L (Total, LDL, and HDL) = mg/dL ÷ 38.6 // Triglyceride mmol/L = mg/dL ÷ 88.5 LDL Cholesterol (Primarytarget of therapy):

  • <100: Optimal
  • 100-129: Near optimal/above optimal
  • 130-159: Borderline high
  • 160-189: High
  • ≥190: Very high

Serum Triglycerides:

  • <150: Normal
  • 150-199: Borderline high
  • 200-499: High
  • ≥500: Very high
Total Cholesterol:

  • <200: Desirable\Recommen.
  • 200-239: Borderline high
  • ≥240: High

HDL Cholesterol:

  • <40: Low
  • ≥60: High
Creatine kinase, serum M: 25-90 U/L // F: 10-70 U/L
Creatinine, serum 0.6-1.2 mg/dL 53-106 µmol/L
Urea nitrogen, serum Cord blood: 21-40 // Premature (1 wk): 3-25 // Newborn: 3-12 // Infant or child: 5-18 // Thereafter: 7-18 mg/dL Thereafter: 2.5-6.4 mmol/L [BUN (mmol/L) = BUN (mg/d)/2.8]
Uric acid, serum 3.0-8.2 mg/dL 0.18-0.48 mmol/L
Glucose, serum Fasting: 70-99 mg/dL (USMLE: 110 mg/dL) (3.8-5.6) mmol/L2-h postprandial: < 120 mg/dL (6.6 mmol/L)
Categories of increased risk for diabetes (prediabetes): FPG: 100-125 mg/dL (5.6-6.9 mmol/L): IFG OR 2-h plasma glucose in the 75-g OGTT: 140-199 mg/dL (7.8-11.0 mmol/L): IGT OR A1C: 5.7-6.4%
Diabetes can be diagnosed with either one of the following four criteria:
(Source: Standards of Medical Care in Diabetes 2011, American Diabetes Association)  Glucose (mmol) = Glucose (mg/dL)/18
1. A1C ≥ 6.5%.The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay. *2. FPG ≥ 126 mg/dL (7.0 mmol/L).Fasting is defined as no caloric intake for at least 8 h.*3. 2-h plasma glucose ≥ 200 mg/dL (11.1 mmol/L) during an OGTT.The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.*4. In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥ 200 mg/dL (11.1 mmol/L)*(*In the absence of unequivocal hyperglycemia, result should be confirmed by repeat testing.)
Lactate dehydrogenase, serum 45-90 U/L
Osmolality, serum 275-295 mOsmol/kg (Osmolality=  2x[Na] + [Glucose]/18 + [BUN]/2.8)
Iron 50-170 µg/dL 9-30 µmol/L
Ferritin, serum M: 15-200 ng/mL
F: 12-150 ng/mL
M: 15-200 µg/L 
F:
 12-150 µg/L
Serum proteins Total (recumbent) 6.0-7.8 g/dL 60-78 g/L
Albumin 3.5-5.5 g/dL 35-55 g/L
Globulin 2.3-3.5 g/dL 23-35 g/L
Immunoglobulins, serum IgAIgE
IgG
IgM
76-390 mg/dL0-380 IU/mL650-1500 mg/dL40-345 mg/dL 0.76-3.90 g/L0-380 kIU/L6.5-15 g/L0.4-3.45 g/L
Serum hormones
Cortisol, serum 0800 h: 5-23 µg/dL
1600 h: 3-15 µg/dL
2000 h: <50% of 0800 h
138-635 nmol/L
82-413 nmol/L
Fraction of 0800 h: <0.50
TSH, serum or plasma 0.5-5.0 µU/mL
Thyroidal iodine (123I) uptake 8%-30% of administered dose/24 h 0.08-0.30/24 h
Thyroxine (T4), serum 5-12 µg/dL 64-155 nmol/L
Triiodothyronine (T3), serum (RIA) 115-190 ng/dL 1.8-2.9 nmol/L
Triiodothyronine (T3) resin uptake 25%-35% 0.25-0.35
LH, serum/plasma
(Range in SI units: Same but in U/L)
M: 6-23 mIU/mL // F: follicular phase 5-30 mIU/mL // midcycle 75-150 mIU/mL // postmenopause 30-200 mIU/mL
PTH, serum, N-terminal 230-630 pg/mL (Pico=10-12 230-630 ng/L (Nano=10-9)
Prolactin, serum (hPRL) <20 ng/mL <20 µg/L
Estriol, total, serum (in pregnancy) 24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL 104-590 nmol/L // 208-970 nmol/L
28-32 wks // 36-40 wks 40-220 ng/mL // 80-350 ng/mL 140-760 nmol/L // 280-1210 nmol/L
FSH, serum/plasma
(Range in SI units: Same but in U/L)
M: 4-25 mIU/mL // F: premenopause 4-30 mIU/mL// midcycle peak 10-90 mIU/mL // postmenopause 40-250 mIU/mL
GH  – arginine stimulation
(Range in SI units: Same but in ug/L)
Fasting: <5 ng/mL // Provocative stimuli: >7 ng/mL
Serum Electrolytes
  1. 1.  Sodium (Na+)
  2. 2.  Potassium (K+)
  3. 3.  Chloride (Cl)
  4. 4.  Calcium, serum (Ca2+)
  5. 5.  Magnesium (Mg2+)
  6. 6.  Bicarbonate (HCO3)
  7. 7.  Phosphorus (inorganic), serum
136-145 mEq/L3.5-5.0 mEq/L95-105 mEq/L8.4-10.2 mg/dL1.5-2.0 mEq/L22-28 (25 ± 3) mEq/L3.0-4.5 mg/dL 136-145 mmol/L3.5-5.0 mmol/L95-105 mmol/L2.1-2.8 mmol/L0.75-1.0 mmol/L22-28 (25 ± 3)  mmol/L1.0-1.5 mmol/L
Arterial Blood Gases (ABGs) (room air)
pHPaCO2 PaO2 7.35-7.45 (7.40 ± 0.05)35-45 (40 ± 5) mm Hg75-105 mm Hg [H+] = 36-44 nmol/L4.7-5.9 kPa10.0-14.0 kPa
Hematological
Erythrocyte count M: 4.3-5.9 million/mm3F: 3.5-5.5 million/mm3 M: 4.3-5.9 x 1012/LF: 3.5-5.5 x 1012/L
ESR (Westergren method) (mm/hr) (Source: Medscape) NB: 0-2 // NB to puberty: 3-13  // M under 50: < 15 // F under 50: < 20 // M over 50: < 20 // F over 50: < 30
Hematocrit or PCV (Packed red cell volume) M: 41%-53%
F: 36%-46%
M: 0.41-0.53
F: 0.36-0.46
Hemoglobin, blood  0-30 days:15.0-24.0 g/dL1-23 mo: 10.5-14.0 g/dL
Until 18:11.5-16.1 (M) // 15.0 (F)…M:13.5-17.5 g/dLF: 12.0-16.0 g/dL
0-30 days:2.32-3.72 mmol/L1-23 mo:1.63-2.17 mmol/LUntil 18: 1.78-2.50 (M) // 2.32 (F)
M:2.09-2.71 mmol/LF: 1.86-2.48 mmol/L
Hemoglobin, plasma 1-4 mg/dL 0.16-0.62 mmol/L
Reticulocyte count 0.5%-1.5% of red cells 0.005-0.015
MCH 25.4-34.6 pg/cell 0.39-0.54 fmol/cell
MCHC 31%-36% Hb/cell 4.81-5.58 mmol Hb/L
MCV 80-100 µm3 80-100 fL (Femto  =10-15)
RDW_CV (Coefficient of Variation) 11.6-14.6% in adult
RDW_SD (Standard Deviation) 39-46 fL
Platelet count 150,000-400,000/mm3 150-400 x 109/L
Partial thromboplastin time (activated) 25-40 s
Prothrombin time 11-15 s
INR 1.0-1.1
Bleeding time (template) 2-7 minutes
Thrombin time <2s deviation from control
Leukocyte count and differential
Leukocyte count (WCC: White Cell Count) 4,500-11,000/mm3 4.5-11.0 x 109/L
  1. 1.    Segmented neutrophils
  2. 2.    Lymphocytes
  3. 3.    Monocytes
  4. 4.    Eosinophils
  5. 5.    Basophils
  6. 6.    Bands
54%-62%25%-33%3%-7%1%-3%0%-0.75%3%-5% 0.54-0.620.25-0.330.03-0.070.01-0.030-0.00750.03-0.05
Volume    Plasma M: 25-43 mL/kg
F: 28-45 mL/kg
M: 0.025-0.043 L/kg
F: 0.028-0.045 L/kg
   Red cell M:20-36 mL/kgF: 19-31 mL/kg M: 0.020-0.036 L/kg
F: 0.019-0.031 L/kg
Sweat
Chloride 0-35 mmol/L (ñ in CF, Ald defeciency, or pseudohypoaldosteronism)
Sodium 5-40 mmol/L
Urine
Oxalate 8-40 µg/mL 90-445 µmol/L
Proteins, total < 150 mg/24 h <0.15 g/24 h
Calcium 100-300 mg/24 h 2.5-7.5 mmol/24 h
Osmolality 50-1400 mOsmol/kg
Sodium, potassium, chloride, and uric acid Vary with intake/diet
Creatinine clearance M: 97-137 mL/min // F: 88-128 mL/min
Estriol, total (in pregnancy):

  • 30 wks
  • 35 wks
  • 40 wks
6-18 mg/24 h9-28 mg/24 h13-42 mg/24 h 21-62 µmol/24 h31-97 µmol/24 h45-146 µmol/24 h
17-Hydroxycorticosteroids M:3.0-10.0 mg/24 hF: 2.0-8.0 mg/24 h 8.2-27.6 µmol/24 h5.5-22.0 µmol/24 h
17-Ketosteroids, total M:8-20 mg/24 hF: 6-15 mg/24 h 28-70 µmol/24 h21-52 µmol/24 h
Urinary dipstick test (mg/dL) Trace: 10-20 // 1+: 30  // 2+: 100 // 3+: 300 // 4+: 1,000-2,000
CSF
Cell count 0-5 cells/mm3 0-5 x 106/L
Chloride 118-132 mEq/L 118-132 mmol/L
Gamma globulin 3-12% total proteins 0.03-0.12
Glucose 40-70 mg/dL 2.2-3.9 mmol/L
Proteins, total < 40 mg/dL < 0.40 g/L
Pressure 70-180 mm H2O
BP Classification (Source: Seventh report of the JNC, 2003, American Heart Association)
SBP (mm Hg) DBP (mm Hg)
Normal <120 and <80
Prehypertension 120–139 or 80–89
Stage 1 Hypertension 140–159 or 90–99
Stage 2  Hypertension ≥160 or ≥100
Body Mass Index (BMI)  (kg/m2(Source: WHO)
Underweight: <18.5 // Normal: 18.5-24.99 // Overweight: 25-29.99 // Obese: ≥ 30 (BMI =  Weight (kg) / Height(m)2)
  • 1 m3 = 103 dm3 = 106 cc = 10mm3 (One cubic meter = One thousand cubic decimeter = One million cubic cm =  One billion cubic mm = one billion uL)
  • 1 L = 1,000 cc = 1,000,000 mm3 = 1,000,000 uL // 1 uL = 1 mm3

 By: Hijazeen, JK. Any feedback?